首页|血清Ang-2、sTREM-1和HMGB1水平与老年重症肺炎合并呼吸衰竭短期转归的关系

血清Ang-2、sTREM-1和HMGB1水平与老年重症肺炎合并呼吸衰竭短期转归的关系

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目的 分析血清Ang-2、sTREM-1 和HMGB1 水平与老年重症肺炎合并呼吸衰竭患者短期转归的关系。方法 本研究纳入 2020 年 1 月～2023 年 5 月老年重症肺炎合并呼吸衰竭患者共 167 例(浙江省永康市中医院 70例，浙江省金华市中心医院 97 例)根据患者 28 天内转归情况(存活/死亡)将其分为存活组(122 例)和死亡组(45 例)，分析两组血清Ang-2、sTREM-1 和HMGB1 水平差异，收集患者一般资料，采用多因素Logistic回归模型分析影响老年重症肺炎合并呼吸衰竭患者短期转归情况的影响因素，并采用受试者工作特征(ROC)曲线模型分析血清Ang-2、sTREM-1 和HMGB1 水平对患者短期转归情况的预测价值。结果 本研究纳入患者至观察终点死亡 45 例，占比26。95%，其中患者死亡时间 5～21 天，中位时间 9(7，14)天;死亡组血清Ang-2、sTREM-1 和HMGB1 水平高于存活组(均P<0。05);Logistic 回归结果显示，吸烟史(β=3。071，OR=21。568，95%CI:1。405-331。121)、高APACHEⅡ评分(β=0。389，OR=1。475，95%CI:1。098-1。982)、高 BNP 水平(β=0。014，OR=1。014，95%CI:1。007-1。022)、高 PCT 水平(β=1。748，OR=5。744，95%CI:1。940-17。006)、低PAB水平(β=-0。051，OR=0。950，95%CI:0。914-0。988)、治疗前高Ang-2 水平(β=2。381，OR=10。816，95%CI:1。070-109。340)、治疗前高sTREM-1 水平(β=0。186，OR=1。204，95%CI:1。068-1。359)、治疗前高HMGB1 水平(β=0。238，OR=1。269，95%CI:1。067-1。509)是老年重症肺炎合并呼吸衰竭患者 28 天内死亡的危险因素(P<0。05);ROC曲线结果显示，治疗前Ang-2 水平、治疗前sTREM-1 水平、治疗前HMGB1 水平及三者联合AUC分别为 0。790、0。904、0。917、0。981，敏感度分别为 93。3%、77。8%、84。4%、68。9%;特异度分别为 87。7%、86。9%、90。2%、94。3%。结论 吸烟史、高APACHEⅡ评分、高BNP水平、高PCT水平、低PAB水平、治疗前高Ang-2 水平、治疗前高sTREM-1水平、治疗前高HMGB1 水平是老年重症肺炎合并呼吸衰竭患者 28 天内死亡的危险因素。临床Ang-2、sTREM-1 及HMGB1 水平对老年重症肺炎合并呼吸衰竭患者的 28 天内转归情况具有一定预测价值。
Analysis of the relationship between serum Ang-2,sTREM-1 and HMGB1 levels and short-term outcomes in elderly patients with severe pneumonia complicated with respirato-ry failure
Objective The relationship between serum Ang-2、sTREM-1 and HMGB1 levels and short-term out-comes in elderly patients with severe pneumonia complicated with respiratory failure was analyzed.Methods This study included 167 elderly patients with severe pneumonia and respiratory failure admitted to Yongkang Hospital of Traditional Chinese Medicine(70 cases)and Jinhua Central Hospita(97 cases),Zhejiang Province from January 2020 to May 2023 as the research object.According to the outcome(survival,death)within 28 days,the patients were divided into a survival group(122 cases)and a death group(45 cases).The differences in serum Ang-2、sTREM-1 and HMGB1 levels between the two groups were analyzed.The general data of patients were collected.The binary logistic regression model was used to analyze the influencing factors of short-term outcomes in elderly patients with severe pneumonia complicated with respiratory failure.The receiver operating characteristic(ROC)curve model was used to analyze the predictive value of serum Ang-2,sTREM-1 and HMGB1 levels on the short-term outcome of patients.Results In this study,45 patients died from the end of observa-tion,accounting for 26.95%.The death time of patients was 5～21 days,and the median time was 9(7,14)days.The levels of serum Ang-2、sTREM-1 and HMGB1 in the death group were significantly higher than those in the survival group(all P<0.05).Logistic regression results showed that smoking history(β=3.071,OR=21.568,95% CI:1.405-331.121),high APACHE II score(β=0.389,OR=1.475,95% CI:1.098-1.982),high BNP level(β=0.014,OR=1.014,95% CI:1.007-1.022),high PCT level(β=1.748,OR=5.744,95% CI:1.940-17.006),low PAB level(β=-0.051,OR=0.950,95% CI:0.914-0.988),high Ang-2 level before treatment(β=2.381,OR=10.816,95% CI:1.070-109.340),high sTREM-1 level before treatment(β=0.186,OR=1.204,95% CI:1.068-1.359),and high HMGB1 level before treatment(β=0.238,OR=1.269,95% CI:1.067-1.509)were risk factors for death within 28 days in elderly patients with severe pneumonia complicated with respiratory failure.Conclusion Smoking history、high APACHE II score、high BNP level、high PCT level、low PAB level、high Ang-2 level be-fore treatment、high sTREM-1 level before treatment and high HMGB1 level before treatment were risk factors for death within 28 days in elderly patients with severe pneumonia complicated with respiratory failure.The levels of clinical Ang-2、sTREM-1 and HMGB1 have certain predictive values for the prognosis of elderly patients with severe pneumonia complicat-ed with respiratory failure within 28 days.

severe pneumonia in the elderlyrespiratory failureAng-2sTREM-1HMGB1short-term outcome

杨巧媛、陈灵敏、张骏

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永康市中医院,浙江 永康 321300

金华市中心医院,浙江 金华 321001

老年重症肺炎 呼吸衰竭 Ang-2 sTREM-1 HMGB1 短期转归

2024

浙江实用医学
浙江省医学情报研究所

浙江实用医学

影响因子：0.606
ISSN：1007-3299
年,卷(期)：2024.29(2)